FULTON AND MUTHIGANI: Let’s give blood now and more often

0

By NICOLE FULTON
More by this Author

By WANGUI MUTHIGANI
More by this Author

A medical doctor in Nairobi painfully recalls how his wife died as he watched.

She had been taken to the hospital to deliver their third child.

She had had a healthy pregnancy, and after two hours at the hospital, she delivered a bouncing baby girl.

Then she started bleeding profusely, what doctors call post-partum haemorrhage (PPH).

She was given standard treatments for the PPH, including medication, IV fluids, and uterine massage.

But she needed blood urgently. There was none. The doctor remembers the hospital staff running around as they made frantic calls, in vain. He sat and watched his wife slip away.

Says he: “She was breathless and faint. She had slowly deteriorated while I watched and couldn’t act to save her. I felt helpless…”

Postpartum haemorrhage is the leading cause of maternal mortality in Kenya, causing one third of childbearing deaths.

Every year, 2,500 Kenyan mothers die from bleeding after delivery.

This is equivalent to 37 Westgate Mall attacks.

The number of mothers that we lose each year to this single, preventable cause would equal 178 fatal matatu crashes.

They would fill the entire indoor gymnasium at the Nyayo National Stadium in Nairobi.

Yet there is no public outcry… People are not lining up in the streets to donate blood.

No M-Pesa paybill number has been set up. So we must ask ourselves, when did we start seeing the death of a childbearing woman to blood loss as an acceptable outcome?

This essentially is uncontrolled bleeding after childbirth, and it can take a woman’s life in a matter of hours.

Most deaths due to PPH are preventable through medication, blood transfusion, or medical procedures.

All of these interventions require the rapid delivery of high quality services by well-trained health workers in a high performing health system.

As health experts sometimes we like to talk about grand sweeping changes that must be made to save lives.

People say things like ‘We must strengthen the health system’, or ‘The leadership must do more’.

But today, on World Blood Donor Day, let’s be specific. What can be done to eliminate these needless tragedies?

Here are five concrete actions from the individual to the national level: First, at the individual level, become a regular blood donor, start today.

According to the World Health Organisation (WHO), blood donation by just one per cent of a country’s population can meet any nation’s basic blood requirements.

In Kenya, we are not there yet. One commemorative blood donor day each year is not enough to save our mothers.

Hearken to this year’s blood donor campaign theme, “What can you do? Give blood. Give now. Give often”.

Secondly, at the health facility level, essential medicines such as oxytocin and misoprostol, should always be available and of the highest quality, complemented by proven innovations.

Oxytocin and misoprostol are medications that help the uterus to contract, preventing blood loss.

Misoprostol was recently added to the Kenya Essential Medicines List of 2016, and nurses now have the authority to use it.

The use of an innovative device called uterine balloon tamponade has also been shown to manage the haemorrhage.

It uses readily available, affordable materials to limit bleeding in an emergency — a condom, catheter and a syringe plunger.

As a third measure, we need to be more transparent about the hidden costs of blood transfusion.

While the blood may be free, the ‘kit’ it comes in often attracts a fee that is charged to the family members in crisis.

Let us hold the health system accountable to make blood truly free.

This brings us to the national level, where we need to increase the funds allocated to make blood available.

The Kenya National Blood Transfusion service estimates that every pint of donor blood costs some Sh10,000 to produce — including the costs of outreach for blood campaigns, educating the donors, screening, transporting and storing blood, and facilitating safe blood transfusion.

To meet the WHO target, Kenya needs to generate 400,000 pints of blood a year.

At current funding levels, we are struggling to hit the half-way mark of this goal.

The number of regional and county blood centres should be increased to ensure that the highest standards and quality for blood transfusion services and blood storage are brought closer to every Kenyan.

Together, we must all reject this number. We should not agree to lose 2,500 mothers every year to a preventable cause.

The change starts with all of us when we expect and demand more, for all women.

 Ms Fulton is the team leader of Options, a women and children’s health NGO, and Dr Muthigani, the manager, Maternal and Newborn Health Programme, Ministry of Health

rn rn

You might also like

Leave a comment